2015-09-23T11:25:15-05:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2014-01-01 366090694 BOILERMAKERS NATIONAL HEALTH & WELFARE FUND BOIL 9133426555 754 MINNESOTA AVENUE NO 110 KANSAS CITY KS 66101 RONNIE TRAXLER CHAIRMAN 9133426555 2015-09-21 1 DOUG BERTOSSI P00637990 6123764500 2014 2016-02-25 16:41:14Z RONNIE TRAXLER 754 MINNESOTA AVENUE NO 110 KANSAS CITY KS 66101 866339119 0 X WWW.BNF-KC.COM X 1954 KS TO PROVIDE HEALTH AND WELFARE BENEFITS 15 15 0 15 0 0 0 0 247424076 277896183 18616505 14190429 145386 488376 266185967 292574988 0 0 236593566 70237085 1470120 1188081 0 0 0 17049769 8857675 255113455 80282841 11072512 212292147 859040618 896819649 263239824 71122861 595800794 825696788 TO PROVIDE HEALTH AND WELFARE BENEFITS 0 0 PROVIDE HEALTH AND WELFARE BENEFITS FOR PARTICIPANTS AND THEIR DEPENDENTS 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 15 0 1 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 0 0 0 X TONYA PAVELAC-WALKER 9139067497 753 STATE AVE STE 106 KANSAS CITY KS 66101 X RONNIE TRAXLER MANAGEMENT TRUSTEE - CHAIRMAN 1.70 X X 0 0 0 KENNETH WASILEWSKI MANAGEMENT TRUSTEE - VICE CHAIRMAN 1.00 X X 0 0 0 JOHN FULTZ SEE SCHEDULE O 1.70 X X 0 0 0 PATRICK GALLAGHER SEE SCHEDULE O 2.00 X X 0 0 0 MARK VANDIVER SEE SCHEDULE O 1.00 X 0 0 0 JOHN CAMMUSO MANAGEMENT TRUSTEE 0.70 X 0 0 0 J MICHAEL CARROLL MANAGEMENT TRUSTEE 0.90 X 0 0 0 MIKE DOLAN MANAGEMENT TRUSTEE 0.40 X 0 0 0 JOSEPH REYNOLDS MANAGEMENT TRUSTEE 1.10 X 0 0 0 NELSON JORDAN MANAGEMENT TRUSTEE 0.90 X 0 0 0 MARK KEFFELER SEE SCHEDULE O 0.60 X 0 0 0 JOHN CLARK JR SEE SCHEDULE O 1.00 X 0 0 0 TYLER BROWN SEE SCHEDULE O 0.90 X 0 0 0 VAN STEPHENS SEE SCHEDULE O 1.10 X 0 0 0 CLAY HERFORD SEE SCHEDULE O 0.90 X 0 0 0 LORI JASPERSON LEAD / H&W DIRECTOR 23.30 X 88416 0 36402 88416 0 36402 0 0 0 0 CIGNA HEALTH AND INSURANCE COMPANY 900 COTTAGE GROVE ROAD BLOOMFIELD CT 06002 ADMINISTRATIVE SERVICES 9504896 WILSON-MCSHANE CORPORATION 754 MINNESOTA AVENUE KANSAS CITY KS 66101 MANAGEMENT SERVICES 2493020 BRANDYWINE GLOBAL INVESTMENT MANAGEMENT 155 MONTGOMERY ST SUITE 611 SAN FRANCISCO CA 94104 INVESTMENT MANAGER 614733 BLAKE & UHLIG PA 753 STATE AVENUE SUITE 475 KANSAS CITY KS 66101 PROFESSIONAL SERVICES 416665 INVESCO 1101 CALIFORNIA STREET SUITE 1900 SAN FRANCISCO CA 94111 INVESTMENT MANAGER 358327 13 EMPLOYER CONTRIBUTIONS 525100 225306405 225306405 EMPLOYEE CONTRIBUTIONS 525100 47674540 47674540 PRESCRIPTION REBATES 525100 4698231 4698231 DELINQUENT EMPLOYER INTEREST 525100 195854 195854 MEDICARE SUBSIDY 525100 21153 21153 277896183 12335155 12335155 575619405 573764131 1855274 1855274 1855274 MISCELLANEOUS INCOME 525100 216623 216623 DISPOSAL OF ASSETS 525100 146019 146019 SECURITIES LENDING INCOME 525100 125734 125734 488376 292574988 277896183 0 14678805 70237085 602514 194164 339722 51681 2209730 431579 368255 2216409 311660 184168 52128 41059 83716 32394 130385 TRANSITIONAL REINSURANC 2796192 80282841 4027 2411 88899655 49727729 16272817 12290000 37080 59779 32666 32666 0 0 444947673 488037920 308879366 342025944 0 4675866 859040618 896819649 901696 3699619 4387988 4273455 257950140 63149787 263239824 71122861 X 0 0 0 0 595800794 825696788 595800794 825696788 859040618 896819649 212292147 17603847 0 X 0 1 X 1 0 32666 32666 0 0 LIMITED PARTNERSHIPS 172466906 F LIMITED LIABILITY COMPANY 17500000 F 103-12 INVESTMENT ENTITY 152059038 F 342025944 DUE TO RELATED ORGANIZATION 51281 LIABILITY FOR SECURITIES ON LOAN 62607584 CASH OVERDRAFT 490922 63149787 X 307962426 17603847 17603847 290358579 2216409 2216409 292574988 246114432 168048000 168048000 78066432 2216409 2216409 80282841 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE FUND TO HOLD THE FUND'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) UNDER THE INTERNAL REVENUE CODE (IRC) AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST OBTAINED ITS LATEST TAX EXEMPTION LETTER, DATED JUNE 29, 1956, IN WHICH THE INTERNAL REVENUE SERVICE STATED THAT THE TRUST, AS THEN DESIGNED, WAS IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THE TRUST HAS BEEN AMENDED SINCE RECEIVING THE TAX EXEMPTION LETTER. HOWEVER, THE PLAN ADMINISTRATOR AND THE PLAN'S COUNSEL BELIEVE THAT THE TRUST IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, THEY BELIEVE THAT THE TRUST WAS QUALIFIED AND THE RELATED TRUST WAS TAX EXEMPT AS OF THE FINANCIAL STATEMENT DATE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2011. PART XII, LINE 2D - OTHER ADJUSTMENTS: PRIOR YEAR BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION B, LINE 11 COPIES OF FORM 990 WERE PROVIDED TO THE GOVERNING BODY MEMBERS BY EMAIL PRIOR TO THE FORM 990 BEING FILED, AND IS REVIEWED BY TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION DOES REQUIRE ANNUAL DISCLOSURES FOR POTENTIAL CONFLICTS OF INTEREST OF ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST, WHICH ARE REVIEWED BY THE ORGANIZATION. THE AFFECTED TRUSTEE OR EMPLOYEE MUST CEASE PARTICIPATION IN THE DECISION OR TRANSACTION UNTIL IT IS DETERMINED THAT THE AFFECTED TRUSTEE OR EMPLOYEE MAY CONTINUE TO PARTICIPATE IN THE DECISION OR TRANSACTION. POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE ALSO REVIEWED FOR COMPLIANCE WITH ERISA REQUIREMENTS. THE ORGANIZATION DOES REQUIRE FULL DISCLOSURE FOR PETENTIAL CONFLICTS OF INTEREST WHEN CONDUCTING SEARCHES FOR NEW VENDORS AND SERVICE PROVIDERS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENT, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990 PART VII, SECTION A, LINE 1A: THE FOLLOWING TRUSTEES ARE COMPENSATED BY A NON-PROFIT RELATED ORGANIZATION AND COMPENSATION INFORMATION WILL BE MADE AVAILABLE UPON REQUEST. JOHN T. FULTZ, UNION TRUSTEE - SECRETARY PATRICK M. GALLAGHER, UNION TRUSTEE - ASST. SECRETARY MARK VANDIVER, UNION TRUSTEE MARL KEFFELER, UNION TRUSTEE JOHN CLARK JR., UNION TRUSTEE TYLER BROWN, UNION TRUSTEE VAN G. STEPHENS, UNION TRUSTEE CLAY HERFORD, UNION TRUSTEE INT'L BROTHERHOOD OF BOILERMAKERS LOCAL LODGE NO ONE IBB - BOILERMAKERS LOCAL 4 BOILERMAKERS LOCAL LODGE NO 5 INT'L BROTHERHOOD OF BOILERMAKERS LODGE 7 BOILERMAKERS LOCAL 11 INT'L BROTHERHOOD OF BOILERMAKERS LOCAL LODGE NO 13 BOILERMAKERS LOCAL 26 BOILERMAKERS LOCAL 27 BOILERMAKERS LOCAL #28 INT'L BROTHERHOOD OF BOILERMAKERS LODGE 29 INT'L BROTHERHOOD OF BOILERMAKERS LOCAL LODGE NO 37 INT'L BROTHERHOOD OF BOILERMAKERS LOCAL #40 INT'L BROTHERHOOD OF BOILERMAKERS LOCAL 45 INT'L BROTHERHOOD OF BOILERMAKERS DISTRICT #57 BOILERMAKERS LOCAL LODGE #60 BOILERMAKERS LOCAL 69 BOILERMAKERS LOCAL 83 INT BRO OF BOILERMAKERS LOCAL LODGE 85 INT'L BROTHERHOOD OF BOILERMAKERS LOCAL 92 IBB LOCAL 101 INT'L BROTHERHOOD OF BOILERMAKERS LOCAL LODGE 105 INT'L BROTHERHOOD OF BOILERMAKERS IRON SHIP BUILDERS BLACKSMITHS FORGERS INT'L BROTHERHOOD OF BOILERMAKERS BIRMINGHAM LOCAL 108 BOILERMAKERS LOCAL 110 BOILERMAKERS LOCAL LODGE 154 BOILERMAKERS LOCAL 169 INT'L BROTHERHOOD BOILERMAKERS 193 LODGE INT'L BROTHERHOOD OF BOILERMAKERS LOCAL LODGE 237 INT BRO OF BOILERMAKERS IRON SHIP BUILDERS BLACKSMITHS FORGERS & HELPERS INT BRO OF BOILERMAKERS IRON SHIP BUILDERS BLACKSMITHS FORGERS & HELPERS BOILERMAKERS LOCAL 374 INT'L BROTHERHOOD - BOILERMAKERS LODGE #433 INT'L BROTHERHOOD OF BOILERMAKERS LOCAL 454 BOILERMAKER LOCAL 455 INTL BROTHERHOOD OF BOILERMAKERS LOCAL LODGE 456 INT'L BROTHERHOOD OF BOILERMAKERS UNION LOCAL 502 INT BRO OF BOILERMAKERS IRON SHIP BUILDERS BLACKSMITHS FORGERS & HELPERS BOILERMAKERS LOCAL 627 INT'L BROTHERHOOD OF BOILERMAKERS LOCAL LODGE #647 INT BROTHERHOOD OF BOILERMAKERS IRON SHIP BUILDERS BLACKSMITHS FORGERS & INT'L BROTHERHOOD OF BOILERMAKERS LOCAL 693 INT'L BROTHERHOOD OF BOILERMAKERS LOCAL LODGE 744 LOCAL 107 DEVELOP & TRAINING FUND WESTERN STATES JOINT APPRENTICESHIP COMMITTEE BOILERMAKERS LOCAL LODGE #549 APPRENTICESHIP & TRAINING TRUST FUND LOCAL 374 DEVELOPMENT AND TRAINING FUND BOILERMAKERS LOCAL 85 JOINT TRAINING & EDUCATIONAL TRUST FUND GREAT LAKES AREA BOILERMAKERS APPR PROGRAM INT'L BROTHERHOOD OF BOILERMAKERS LONE STAR DISTRICT LODGE INTERNATIONAL BROTHERHOOD OF BOILERMAKERS 5 DISTRICT MISSISSIPPI RIVER SOUTHEASTERN AREA JOINT APPRENTICESHIP COMMITTEE INT'L BROTHERHOOD OF BOILERMAKERS LOCAL LODGE #647 DEV & TRAINING FUND INT'L BROTHERHOOD OF BOILERMAKERS NORTHEAST AREA APPRENTICESHIP COMMITTEE BOILERMAKERS NATIONAL APPRENTICESHIP PROGRAM (ADMINISTRATIVE) CITY OF LOS ANGELES - DEPARTMENT OF WATER AND POWER MOBILIZATION OPTIMIZATION STABILIZATION & TRAINING BOILERMAKERS NATIONAL H&W CANADA ASBESTOS WORKERS LOCAL 2 SHEET METAL WORKERS L 7 ZONE 1 UA LOCAL 13 PLUMBERS & STEAMFITTERS L 22 IRONWORKERS LOCAL 25 ASBESTOS WORKERS LOCAL 38 PLUMBERS AND STEAMFITTERS L 52 IRON WORKERS LOCAL 55 SHEET METAL WORKERS LOCAL 80 U A LOCAL 85 PLUMBERS LOCAL 98 CARPENTERS & MILLWRIGHTS 1102 EMPIRE STATE CARPENTERS PIPEFITTER LOCAL 174 SHEET METAL WORKERS L 2 PLUMBERS & PIPEFITTER L 333 UA PLUMBERS LOCAL 357 FLINT PLMING& PIPEFTING L370 IRONWORKERS LOCAL 549 & 550 NYC DISTRICT OF CARPENTERS IRON WORKERS LOCAL 6 PIPEFITTERS LOCAL 636 ADVANCED PROJECT CONTROLS AMERICAN REFRACTORY CO LLC FUEL TANK MAINTENANCE COMPANY GRACON CORPORATION GULF COAST IND MAINT LLC LIQUIDMETAL WELDING LLC LUCKY MECHANICAL LLC SOUTHERN ILLINOIS BOILER SELINSKY FORCE LLC SKANSKA SNC LAVALIN JV ALLOY CLADDING CO INC LLC DIAMOND INSPECTION SERVICES LLC FRESH MEADOW POWER LLC FRESH MEADOW POWER-NE LLC GUBMK CONSTRUCTORS GEAR TECH MECHANICAL LLC GIBRALTAR CHIMNEY INT'L LLC HAYES MECHANICAL ICON MECHANICAL CONSTRUCTION & ENGINEERING LLC PLIBRICO COMPANY LLC SAFWAY SERVICES LLC TURNER INDUSTRIAL MAINTENANCE LLC VULCAN INDUSTRIAL CONTRACTORS CO LLC AZZ WSI LLC BAUM STEEL CONSTRUCTION INC CONSTRUCTION & TURNAROUND SERV CONTRACTORS CARGO CO MADISON INDUSTRIAL SERVICES MC CARL'S FAB SHOP SOUTHERN IND CONST INC DBA STALCON PROJECT CONTROL SERVICES INC SAVANNAH RIVER NUCLEAR SOLUTION WOOD MILTON J COMPANY ARCHER DAY 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